Study Supports Follow-Up Consultations After Heart Failure

Medscape

4 hours ago

About 40% of patients with diagnosed heart failure did not pursue future cardiology consultations, regardless of the initial severity of their condition. A single follow-up cardiology visit can reduce 1-year all-cause mortality by 6%-9%, with additional visits showing increased benefit as the severity of heart failure increases.
METHODOLOGY:
A nationwide cohort study included 655,919 French patients (median age, 80 years; 48% women) diagnosed or hospitalized with heart failure between January 1, 2015, and December 31, 2019, and who were still alive on January 1, 2020.
Researchers categorized patients into four groups: Those hospitalized with heart failure within the past year, those hospitalized with the condition between 1 and 5 years prior, patients not hospitalized but who were receiving loop diuretics, and patients who were not hospitalized and were not taking loop diuretics.
TAKEAWAY:
The 1-year risk for all-cause mortality ranged from 8% in patients without hospitalization or use of loop diuretics to 25% for those hospitalized for heart failure within the past year.
Mortality risk increased progressively across groups, with an adjusted hazard ratio of 1.61 for patients using loop diuretics, 1.83 for patients using loop diuretics and hospitalized over 1 year prior, and 2.32 for patients hospitalized less than 1 year prior ( P < .0001 for all).
< .0001 for all). A single cardiology consultation was associated with a 6%-9% absolute reduction in 1-year all-cause mortality across all groups.
The optimal follow-up strategy varied by risk group: One annual visit for low-risk patients, two to three visits for intermediate-risk patients, and four visits for high-risk patients recently hospitalized with heart failure.
IN PRACTICE:
'Despite having an HF diagnosis, 40% of patients do not see a cardiologist annually, regardless of disease severity. Simple stratification based on hospitalization history and diuretic use effectively predicts outcomes. Tailoring the annual number of [heart failure] consultations according to this stratification could optimize resource use and reduce avoidable modelled deaths,' the researchers wrote.
'This group represents a significant opportunity to improve survival outcomes with only a modest increase in the total number of consultations. Healthcare systems could formally assess the impact of this annual consultation through large-scale cluster trials, allowing for an evaluation of the broader population-level benefits of this approach,' they added.
SOURCE:
The study was led by Guillaume Baudry, MD, of the Université de Lorraine in Nancy, France. It was published online in the European Heart Journal and presented at the Heart Failure Association of the European Society of Cardiology (HFA-ESC) 2025 meeting.
LIMITATIONS:
Researchers excluded patients residing in nursing homes due to their advanced prognosis and unavailability of healthcare utilization data, which may have led to an underestimation of morbidity and mortality. The study did not include heart failure patients who had not been recently hospitalized and did not submit long-term condition paperwork. Important clinical data such as ejection fraction, heart failure phenotype, and prognostic biomarker values were unavailable.
DISCLOSURES:
The researchers reported receiving fees and grants and other relationships with various pharmaceutical companies including Abbott, AstraZeneca, Bayer, and Pfizer.